Foley Cath

[widi96]

xxxxxx

[ninisasa85]

Basically a judgement call, but thought I would get your all's opinion. Had a confused patient that had two drains from his abd, one from an abscess, the other from his previous surgery site (surgery site was completely healed). So he has these two opening to his belly with bandages on them. Pt also has breakdown with stage 2 pressure ulcers to his buttocks. Pt is incont of bowel and bladder and with his IVF, is soaking the bed at least ever hour or two. We got him to use the urinal a couple of times, but each time he dumped it on himself, including on his abd where the drain dressings and openings were. So the patient already has an infection and is a HIGH risk of becoming septic - is it out of line to ask for a foley? The pros being to keep the urine off of his abd wounds/drain sites and keeping it off of his already broken down bottom, which I would think could lead to infection as much as the foley, but the con being the risk of UTI's with a catheter. Our hospital is REALLY pushing to not have catheters unless absolutely medically necessary. What do you all think? Is the repeated incont contaminating the wounds safer medically than a foley?

Hey there,

How about using external catheters, such as a condom sheath. It does help with confused clients, as they can pass urine without the spill. Besides having an indwelling urinary cathteter may cause irritation to the clients causing them to leak and urinate more often.

[icyounurse, BSN, RN]

Umm, I would definetely ask for a foley in this case. Urine+wounds+skin breakdown=higher risk than catheter in my opinion. :)

[widi96]

Great idea! Do you have to have an order for a condom cath since they aren't considered invasive?

[widi96]

(I did ask for the cath and got jumped by the doc saying he would get septic and we would never get it out of him - the doc didn't see the urine covered dressings we had to change though)

[czyja, MSN, RN]

I agree w/ the above poster. Strikes me that a condom cath would be a good solution here.

[Simba&NalasMom, LPN]

Most condom caths I've dealt with either slide off or get pulled off by agitated/confused people. Do they have some sort of condom cath superglue that works?

[ninisasa85]

Hey there,

I'm no sales person here promoting condom sheaths. hahaha. Well, i came across a self sealing condom external catheters by conveen. It's quite new in the market. Hope that this useful for you all. Thanks.

[ninisasa85]

Hey there,

I came across a self sealing condom catheters recently. Hope that this will help.

[CoffeeRTC, BSN, RN]

Very common situation in LTC. The answer would be no. We would be required to check and change this person more frequently. Yeah....soemtimes q 2 hr changes are hard enough.....do the math with 10+ more persons on a CNAs assignment.

Now...If it were multiple stage 2s or worse...sometimes we can get one. Look into a good skin barrier. Inct briefs or pads that will wick the urine away from the wounds help too.

[Penelope_Pitstop, BSN, RN]

do you have to have an order for a condom cath since they aren't considered invasive?

find out what your faculty's policy is. i know when i worked medsurg, we kept different sized sheaths in our clean supply closet. no order was required, but sometimes they are more trouble than they are worth (especially in older men because...well, age does things to...certain parts!) it's worth a shot, though! see if your facility has the adhesive for the sheaths.

*~jess~*

[SuesquatchRN, BSN, RN]

A condom cath is one solution.

The other is to keep a chuck on his bottom at all times with it pulled up between his legs and over the tip of his member. It will at least soak up most of the urine and it is very easy to turn, remove, and replace.

Yeah, I think the Foley is the best solution, But you won;t get an order for it.